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PICO: Form a Focused Clinical Question

Formulate a Clinical Question from a Case Study

Clinical Scenario

A 68-year-old female patient has recently been diagnosed with high blood pressure. She is otherwise healthy and active. You need to decide whether to prescribe her a beta-blocker or an ACE inhibiter.

 

Image: "Blood pressure measuring. Doctor and patient. Health care." by agilemktg1 is marked with CC PDM 1.0

 

► Click on the P: Patient tab to proceed in developing a clinical question.

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

P: Patient

Consider when choosing your patient/problem:

  • What are the most important characteristics?
  • Relevant demographic factors
  • The setting

 

Patient: adult hypertensive female

 

Image: "Nurse measuring blood pressure of senior woman at home. Looking at camera, smiling.?" by agilemktg1 is marked with CC PDM 1.0

 

► Click on the I: Intervention tab to proceed in developing a clinical question.

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

I: Intervention

Consider for your intervention:

  • What is the main intervention, treatment, diagnostic test, procedure, or exposure?
  • Think of dosage, frequency, duration, and mode of delivery

 

Intervention: beta-blocker

Image: "Atenolol Blood Pressure Tablets Image 4" by Doctor4U_UK is licensed under CC BY 2.0

 

► Click on the C: Comparison tab to proceed in developing a clinical question.

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

C: Comparison

Consider for your comparison:

  • Inactive control intervention: Placebo, standard care, no treatment
  • Active control intervention: A different drug, dose, or kind of therapy

 

Comparison: ACE inhibiter

Image: "Ramipril Blood Pressure Capsules Image 5" by Doctor4U_UK is licensed under CC BY 2.0

 

 

► Click on the O: Outcome tab to proceed in developing a clinical question.

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

O: Outcome

Consider for your outcome:

  • Be specific and make it measurable
  • It can be something objective or subjective

 

Outcome: relief of symptoms; controlled blood pressure

Image: "File:BP B6 Connect blood pressure monitor.png" by 百略醫學 is licensed under CC BY-SA 4.0

 

► Click on the PICO: Putting It Together tab to proceed in developing a clinical question.

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

Formulate a PICO Question

 

Answerable PICO Question: In middle-aged adult females with hypertension, are beta blockers more effective than ACE inhibiters in controlling blood pressure?

 

Image: "Dagstuhl 2008-02-01 - 37" by Nic's events is licensed under CC BY-SA 2.0

 

Suggested MeSH Terms: Adrenergic beta-Antagonists/therapeutic use; Angiotensin-Converting Enzyme Inhibitors/therapeutic use; hypertension/drug therapy

Tip: Incorporating sex into the search may not be necessary unless there is a significant difference between males and females in relevant studies. 

(Case study from EBM Librarian: Teaching Tools: Scenarios.)

Click "Next" below to practice formulating clinical questions using PICO format.